Remote Utilization Management RN - Care Coordination
Humana
Utilization Management Registered Nurse at Humana uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care services including SNF, Home Health and DME. You will report to the Manager of Utilization Management and serve as a member of the One Home/Home Solutions Utilization Management team, focused on ensuring members receive appropriate care in the most suitable setting. #J-18808-Ljbffr
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations... ...Management team handling post-acute care services (SNF, Home Health, DME) to ensure appropriate...Remote workWork from home
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ..., which oversees post-acute care services including SNF, home... ...necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
- Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote job
- Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. The role reports to the Manager of Utilization...Remote job
- ...Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote team on weekends after training. You will review... ...determinations and collaborate with providers to coordinate care, ensuring members receive appropriate care....Remote jobWork at officeWeekend work
- Highmark Inc. is seeking a full-time RN with utilization management expertise for a remote role requiring weekend availability (Saturday... .... The position focuses on reviewing care appropriateness, applying criteria, and coordinating with Health Coach/case management to...Remote jobFull timeWeekend workWeekday work
$47.37 per hour
Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care, and ensure... ...regulations. The role requires an active RN/LPN/LVN license and 2-4 years of clinical...Remote jobHourly pay- Humana Inc is seeking a Utilization Management Registered Nurse to interpret and coord intakes for medical services and benefit determinations in a fully remote capacity. You will support post-acute care services across SNF, Home Health and DME, reporting to the Utilization...Remote job
$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’s managed care health plan client based out of Redding or Fairfield, CA. Anticipating to be temporary for at least...Remote workContract workTemporary workMonday to FridayWeekend work$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote ~ Full-time WHO IS GUIDEHEALTH? Guidehealthis a data... ...services Quality of care concerns Interfacingroutinely... ...reliable and user-friendly. Care Coordination & Quality Support Initiatingreferrals...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...Utilization Management RN (Part-Time, Remote) Position Overview Under the direction of a designated... ...recommends alternative levels of care when appropriate. This role supports... ...Inpatient Acute Care Nursing Care Coordination Telephonic Clinical Review...Remote workPart timeMonday to Friday
- ...Humana Inc. is hiring a Utilization Management Registered Nurse for remote work. You will apply clinical nursing expertise to interpret, coordinate, document, and communicate medical services and... ...determinations for post-acute care settings. You will make criteria...Remote work
- ...is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate member outcomes...Remote work
$47.03 - $63.48 per hour
...enabled revenue cycle management solutions for health... ...healthcare. The RN, Senior Utilization Review Quality... ...management denials. Coordinate with service line leaders... ...experience in an acute care environment required... ...experiences This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area$63.1k - $94.65k
...enabled revenue cycle management solutions for... ...have current compact RN license, or be... ...Information: Our Utilization Review team provides... ...of health care resources and assists... ...Denial Management Coordinates the P2P process with... ...: This is a remote role which requires...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$101.72k - $198.36k
...California - Ability to work remote, but selected candidate... ...position requires California RN Licensure. Candidates must... ...of the following functions: utilization management, care management, behavioral health... ...facilitating, planning and coordinating integrated delivery of care...Remote workContract workWork experience placementWork at officeLocal area$39.4 - $53 per hour
...enabled revenue cycle management solutions for health... ...healthcare. The Lead Utilization Review RN is a key contributor... ...-oriented, patient care delivery system, which... ...MANAGEMENT: Coordinates the appeal process with... ...required #LI-LS1 #LI-REMOTE Join an award-winning...Remote workWork at officeLocal area- ...Behavioral Health Utilization Manager Behavioral Health Utilization Manager... ...in the appropriate level of care. Notifies Medical Director... ...turnaround times. Assists in the coordination of care of hospitalized... ...systems Work Schedule: Remote Other Requirements: Able to...Remote workContract workWork experience placement
- Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations... ...Management team focused on post-acute care (SNF, Home Health, DME). The role emphasizes using...Remote job
- Elevance Health is seeking a Wound Care Utilization Management RN to support pre-certification and authorization... ...Services. This role emphasizes remote work with essential in-person... ...sessions and a strong focus on care coordination and outcomes. You will review clinical...Remote job
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical... ...and support the coordination, documentation and communication... ...Compact Registered Nurse (RN) license in your state of... ...Experience working in a fully remote, metrics-focused role...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeHome office- ...RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage...Work at officeWork from homeHome officeMonday to FridayWeekend workWeekday work
- HealthEdge is seeking a Telephonic Utilization Management RN to coordinate, document, and communicate all aspects of the utilization/benefit management... ...clinical needs, review authorization requests, and ensure care plans align with medical necessity across inpatient and...Remote job
- ...Nurse to assess, plan, implement, and coordinate healthcare services and benefits for... ...collaborate with providers to facilitate care and treatment. You will identify... ...resource to internal and external stakeholders in utilization/benefit management. #J-18808-Ljbffr CVS HealthRemote job
- ...experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on... ...collaborate with providers to coordinate treatment plans, ensuring appropriate care and utilization. The position requires 3+ years RN experience, an active RN license,...Remote job
- ...Description: Home Care & Hospice Virtual Care Center Coordinator Registered Nurse (RN) Hiring for the following... ...critical moments. Utilizing virtual platforms,... ...Leadership - Accessible managers who understand the... ...patients' conditions remotely. Develop and...Remote workFull timeTemporary workPart timeReliefLocal areaImmediate startMonday to FridayShift workWeekend work
- Elevance Health is seeking a Wound Care Utilization Management RN to perform pre-certification and authorization... ...needs. You will review records, coordinate with physicians and home health... ...for continuity of care. This largely remote role requires in-person training...Remote jobMonday to FridayShift work
- ...Find your calling at Mercy! Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate... ...with patient throughput; collaborating to include coordination as evidenced by metrics, optimizing performance...Remote workFull time
- ...Partners is seeking a Virtual Utilization Review Specialist to join our remote team. You will perform medical necessity reviews, manage denials, and coordinate with FCC and care management to optimize... ...Qualified candidates hold a current RN license, have at least 1 year...Remote job
- CVS Health is seeking an Utilization Management Nurse Consultant to assess, plan, implement, coordinate, monitor, and evaluate healthcare... ...role requires a skilled RN with experience in acute/critical care and utilization management, offering remote work in California and a...Remote jobFull timeAfternoon shift
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